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P Ioannou, M Stavroulaki, V Mavrikaki, I Papakitsou, S Panagiotakis
WHAT IS KNOWN AND OBJECTIVE: Hyponatremia is the most common electrolyte disorder. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the main cause of euvolemic hyponatremia and is often associated with medications or underlying diseases. Linezolid is a potent antibiotic against resistant Gram-positive microorganisms that has been associated with mild hyponatremia, yet with a mechanism different from SIADH. CASE SUMMARY: We present the case of a patient who developed severe hyponatremia during treatment with linezolid for an ampicillin-resistant E...
March 14, 2018: Journal of Clinical Pharmacy and Therapeutics
Rocío Martínez, Carlos Torrente
A 3-month-old intact male Prague ratter was presented to the emergency service for evaluation of progressive lethargy, weakness, coughing and labour breathing after an episode of resistance to oral deworming. The patient exhibited depression, increased respiratory effort and cyanosis at initial presentation. Results of first diagnostic work-up (complete blood cell count, biochemistry panel and thoracic x-rays) were all consistent with aspiration pneumonia. The puppy was initially treated with balanced isotonic crystalloids, broad spectrum antibiotics, nebulization with thoracic coupage and was transferred to an infant incubator with a sustained FiO2 of 40-50%...
December 2017: Topics in Companion Animal Medicine
Nicholas Black, Hazim Hamada
An 80-year-old woman presented with a 5-week history of increasing confusion. Examination was remarkable only for deficits in short-term memory and paranoid thoughts. Blood tests revealed hyponatraemia, and further biochemical testing was consistent with syndrome of inappropriate antidiuretic hormone (SIADH). After an exhaustive diagnostic workup for causes of SIADH, the only abnormal finding was a mildly raised antivoltage-gated potassium channel (VGKC) titre of 185 pmol/L (0-69) consistent with possible anti-VGKC autoimmune limbic encephalitis...
March 7, 2018: BMJ Case Reports
Jesse H Morris, Nicole M Bohm, Branden D Nemecek, Rachel Crawford, Denise Kelley, Bhavna Bhasin, Paul J Nietert, Juan Carlos Q Velez
BACKGROUND: Tolvaptan effectively corrects hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but undesired overcorrection can occur. We hypothesized that pretherapy parameters can predict the rapidity of response to tolvaptan in SIADH. STUDY DESIGN: Multicenter historical cohort study. SETTING & PARTICIPANTS: Adults with SIADH or congestive heart failure (CHF) treated with tolvaptan for a serum sodium concentration ≤ 130 mEq/L at 5 US hospitals...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jennifer Hague, Ruth Casey, Jonathan Bruty, Tom Legerton, Stephen Abbs, Susan Oddy, Andrew S Powlson, Mohamed Majeed, Mark Gurnell, Soo-Mi Park, Helen Simpson
Activating mutations in AVPR2 are associated with nephrogenic syndrome of inappropriate antidiuresis (NSIAD). NSIAD causes hyponatremia, decreased serum osmolality and clinical symptoms, which may present from birth or in infancy and include hypotonia, irritability, vomiting and/or seizures. Symptoms in later life are often less specific and include malaise, dizziness, confusion, tiredness and headache. NSIAD is a rare X-linked condition, which is associated with a variable phenotype in males, of whom some present in infancy but others do not become symptomatic until adulthood, or occasionally, never...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Yukiko Abe, Tsutomu Kawasaki, Kazuhiro Shimaya, Toshihisa Ishikawa, Yuki Kata, Kaori Okayasu, Koji Unoura, Yoichi Nakamura
A 47-year old man presented to our hospital with a 6-month history of malaise, cough and dyspnea on exertion. Laboratory testing revealed the severe hyponatremia. A chest X-ray showed bilateral diffuse micronodules. Anti-Trichosporon asahii antibody and environmental provocation test were positive. Bronchoalveolar lavage fluid showed lymphocytosis and low CD4/8 ratio. The specimens obtained by transbronchial lung biopsy revealed alveolitis. Based on these findings, the patient was diagnosed as having summer-type hypersensitivity pneumonitis (SHP)...
2018: Arerugī, [Allergy]
Tzy Harn Chua, Matin Ly, Senthil Thillainadesan, Katie Wynne
Hyponatraemia is common following major head injury and is associated with significant morbidity and mortality. A 20-year-old man presented with reduced consciousness after head trauma and was found to have a fractured skull base with bilateral frontal contusions. On day 3 of his admission, he developed hyponatraemia with raised urine sodium and osmolality, despite receiving dexamethasone and intravenous fluid therapy. His hyponatraemia worsened after the treatment with fluid restriction and oral salt. He was in negative fluid balance suggesting possible renal salt wasting...
February 5, 2018: BMJ Case Reports
Shin Han Song, Gyeong Ah Sim, Seon Ha Baek, Jang Won Seo, Jung Weon Shim, Ja Ryong Koo
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hypo-osmotic hyponatremia. There are several etiologies of SIADH including neuroendocrine tumor, pulmonary disease, infection, trauma, and medications. Here, we report a case of SIADH associated with a schwannoma involving the mediastinum in a 75-year-old woman who presented with nausea, vomiting, and general weakness. Laboratory testing showed hypo-osmolar hyponatremia, with a serum sodium level of 102mmol/L, serum osmolality of 221mOsm/kg, urine osmolality of 382mOsm/kg, urine sodium of 55 mmol/L, and plasma antidiuretic hormone (ADH) of 4...
December 2017: Electrolyte & Blood Pressure: E & BP
Carolina Saldarriaga, Charlampos Lyssikatos, Elena Belyavskaya, Margaret Keil, Prashant Chittiboina, Ninet Sinaii, Constantine A Stratakis, Maya Lodish
OBJECTIVES: To define the incidence and risk factors of postoperative sodium alterations in pediatric patients undergoing transsphenoidal surgery (TSS) for adrenocorticotropic hormone and growth hormone secreting pituitary adenomas. STUDY DESIGN: We retrospectively reviewed 160 patients ≤18 years of age who had TSS for pituitary adenomas at our institution from 1999 to 2017. Variables included daily serum sodium through postoperative day 10, urine specific gravity, and medications administered...
January 30, 2018: Journal of Pediatrics
Aaron C Tan, Gavin M Marx
We present a case of cisplatin-induced syndrome of inappropriate antidiuretic hormone (SIADH) in a patient with metastatic recurrent urothelial carcinoma. Cisplatin-induced SIADH is an uncommon but potentially life-threatening toxicity. Pharmacogenetic characteristics may result in different toxicity profiles in different populations. With such widespread use of cisplatin in a diverse range of cancers, prompt recognition is crucial to detect and prevent severe neurological sequelae.
January 31, 2018: BMJ Case Reports
Teri Tasler, Susan D Bruce
The leading cause of hyponatremia in patients with cancer is syndrome of inappropriate antidiuretic hormone secretion (SIADH); this oncologic emergency requires immediate intervention. Left untreated, it can result in increased mortality and morbidity. A sodium level less than 135 meq/L is an electrolyte irregularity and defined as hyponatremia. It is extremely critical that oncology nurses are knowledgeable and able to evaluate and determine when patients are in fluid and electrolyte crisis. Nurses should be aware of the specific cancers and treatments that put patients at risk for developing hyponatremia...
February 1, 2018: Clinical Journal of Oncology Nursing
Ilaria Fiordoliva, Tania Meletani, Maria Giuditta Baleani, Silvia Rinaldi, Agnese Savini, Marzia Di Pietro Paolo, Rossana Berardi
Hyponatremia is the most common electrolyte disorder in lung cancer patients. This condition may be related to many causes including incidental medications, concurrent diseases and side effects of antineoplastic treatments or the disease itself. Although not frequently life-threatening, it is usually associated with prolonged hospitalization, delays in scheduled chemotherapy, worsening of patient performance status and quality of life and may also negatively affect treatment response and survival. Most of the available data focus on thoracic tumors, especially small-cell lung cancer (SCLC), where hyponatremia is frequently related to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)...
November 2017: Therapeutic Advances in Medical Oncology
Marie Øbro Fosbøl, Anders Bilde, Jeppe Friborg, Eric von Benzon, Andreas Kjær, Christian von Buchwald, Lise Borgwardt
Esthesioneuroblastoma (ENB) is an uncommon neuroendocrine tumor originating from the olfactory neuroepithelium and accounts for 3-6% of all intranasal tumors [¹]. ENBs can be locally aggressive and cause invasion and destruction of surrounding structures. Histological grading and clinical stage at presentation are highly predictive of survival and especially presence of lymph node and distant metastases are determining prognostic factors [²,³,⁴,⁵]. Thus, reliable imaging is essential in these patients...
January 14, 2018: Diagnostics
Ashraf Abugroun, Fatima Ahmed, Toni-Denise Espina, Alvaro Altamirano Ufion
Basaloid squamous cell carcinoma (BSQCC) of the lung is a very rare subtype of squamous cell carcinoma (SCC). There have been no reported cases of syndrome of inappropriate anti-diuretic hormone secretion (SIADH) developing concurrently with this tumor. We herein present a case of a 68-year-old female who was diagnosed with lung mass discovered incidentally on preoperative clearance for surgical fixation of right humeral neck fracture. The patient presented to the hospital with nausea, vomiting, diarrhea and fatigue...
December 2017: World Journal of Oncology
Prakash Babaliche, Siddharth Madnani, Sajal Kamat
Background and Aims: Hyponatremia is the predominant electrolyte abnormality with an incidence rate of approximately 22%. It is the leading cause of morbidity and mortality with scarce data in Indian intensive care settings. The aim of this study is to evaluate the clinical features and etiology of hyponatremia in patients admitted to an Intensive Care Unit (ICU) of a tertiary care hospital. Materials and Methods: A 1-year prospective cross-sectional observational study was conducted, including 100 adult patients with moderate-to-severe hyponatremia admitted to the Medical ICU...
December 2017: Indian Journal of Critical Care Medicine
Gautam Rawal, Raj Kumar, Sankalp Yadav
Hyponatremia is a rare but potentially fatal complication of selective serotonin reuptake inhibitor (SSRI) therapy with only limited cases of escitalopram as the causative drug. We report the case of a 54-year-old hypertensive female who was admitted to the hospital with seizure episode and subsequently diagnosed to have severe hyponatremia due to SSRI-induced syndrome of inappropriate antidiuretic hormone (SIADH) with the cause attributed to the short history of intake of escitalopram for depression. All SSRIs, including escitalopram, can cause SIADH and should be used with caution in the depressive patients with regular monitoring of electrolytes, especially in the elderly...
April 2017: Journal of Family Medicine and Primary Care
Sudha Vidyasagar, Karthik Rao, Muralidhar Verma, Aswini Dutt Tripuraneni, Navin Patil, Dipanjan Bhattacharjee
Hyponatraemia is a well-established and potentially, a life-threatening adverse effect of selective serotonin receptor uptake inhibitors (SSRI). However, its occurrence secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) with escitalopram, has been reported extremely sporadically. The reporting of such rare, but life-threatening adverse effects of escitalopram assumes immense significance in light of the fact that SSRIs presently form the mainstay of treatment of depressive disorders...
September 15, 2017: Psychopharmacology Bulletin
Juanita K Hodax, Shara R Bialo, Ali Yalcindag
Interleukin-6 (IL-6) is implicated in the pathogenesis of both systemic juvenile idiopathic arthritis (SJIA) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but the 2 have not been previously described as occurring together. We report a case of a 6-year-old girl with symptoms of arthralgia, daily fevers, evanescent rash, lymphadenopathy, and laboratory evaluation showing elevated inflammatory markers, consistent with SJIA. At presentation, the patient had hyponatremia with a sodium level of 128 mEq/L...
January 2018: Pediatrics
V Bassi, O Fattoruso, C Santinelli
Hyponatremia is the most common electrolyte abnormality observed in clinical practice and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is diagnosed in nearly 40% of the hospitalized hyponatremic patients. We present a case report of herpes zoster infection causing a severe hyponatremia/hypokalemia. This rare association between SIADH and varicella-zoster virus infection is described in only few case in the literature. In our case report, the associated hypokalemia was not related to the use of diuretics but, probably, dependent on the frank serum hyposmolality able to induce an aldosterone release...
November 2017: Oxford Medical Case Reports
Satoko Oka, Kazuo Ono, Masaharu Nohgawa
Sweet disease may occur in several organs, and central nervous system involvement, known as Neuro-Sweet disease (NSD), is rare. The clinical features of NSD include recurrent encephalomeningitis accompanied by fever and erythematous plaques; systemic corticosteroid therapy is highly effective. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an important electrolyte abnormality because it can be life-threatening. We describe the first case of SIADH and NSD associated with low-risk myelodysplastic syndrome that was successfully treated with corticosteroids and cyclosporine...
February 15, 2018: Internal Medicine
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